U.S. patent application number 16/743771 was filed with the patent office on 2020-05-14 for trocar simulation.
This patent application is currently assigned to Ethicon LLC. The applicant listed for this patent is Ethicon LLC. Invention is credited to Katherine J. Schmid, Cara Shapiro, Eric W. Thompson.
Application Number | 20200146760 16/743771 |
Document ID | / |
Family ID | 60702880 |
Filed Date | 2020-05-14 |
United States Patent
Application |
20200146760 |
Kind Code |
A1 |
Schmid; Katherine J. ; et
al. |
May 14, 2020 |
Trocar Simulation
Abstract
Methods and devices are provided for supporting an elongate
shaft on a surgical tool during robotic surgery. For example, a
tool holder is provided with an elongate carrier arm configured to
couple to a distal end of a surgical robotic arm. The tool holder
has a housing that is removably mounted on the carrier arm and that
is configured to be positioned adjacent to a tissue surface without
extending into tissue. The tool holder thus simulates a trocar. The
housing has an opening formed therethrough for receiving an
elongate shaft of a surgical tool, and the opening has an inner
diameter that is configured to dynamically adjust in size to adapt
to and resist movement of elongate shafts of varying diameters
inserted therethrough.
Inventors: |
Schmid; Katherine J.;
(Loveland, OH) ; Thompson; Eric W.; (Pleasant
Plain, OH) ; Shapiro; Cara; (Milford, OH) |
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Applicant: |
Name |
City |
State |
Country |
Type |
Ethicon LLC |
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Assignee: |
Ethicon LLC
|
Family ID: |
60702880 |
Appl. No.: |
16/743771 |
Filed: |
January 15, 2020 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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15380490 |
Dec 15, 2016 |
10568706 |
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16743771 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2034/104 20160201;
A61B 34/71 20160201; A61B 2017/347 20130101; A61B 17/3423 20130101;
A61B 17/3462 20130101; A61B 34/10 20160201; A61B 90/50 20160201;
A61B 34/30 20160201; A61B 2017/3409 20130101; A61B 2017/3492
20130101; A61B 34/70 20160201; A61B 90/361 20160201 |
International
Class: |
A61B 34/30 20060101
A61B034/30; A61B 34/00 20060101 A61B034/00; A61B 17/34 20060101
A61B017/34; A61B 90/50 20060101 A61B090/50; A61B 90/00 20060101
A61B090/00; A61B 34/10 20060101 A61B034/10 |
Claims
1. A surgical method, comprising: inserting an elongate shaft of a
surgical tool into an opening of a tool holder mount on a distal
end of a surgical robotic arm, the tool holder being positioned
adjacent to a tissue surface without extending into tissue, the
opening dynamically adapting in size to have an inner diameter that
substantially corresponds to an outer diameter of the elongate
shaft such that the tool holder resists angular forces applied to
the elongate shaft to minimize a bending load applied to the
shaft.
2. The method of claim 1, wherein the opening has at least one
biasing member that biases the elongate shaft toward a center of
the opening to resist angular forces applied to the elongate
shaft.
3. The method of claim 2, wherein the at least one biasing member
comprises at least one of ribs, spring-biased centering balls,
spring-biased arms, semi-segmented balloons, and an elastomeric
squeeze fit material.
4. The method of claim 1, wherein the opening includes a plurality
of spring-biased members that are biased toward a central axis of
the opening to adjust a size of the inner diameter of the
opening.
5. The method of claim 1, wherein the opening includes at least one
deformable member that deforms to adjust a size of the inner
diameter of the opening.
6. The method of claim 1, wherein the tool holder is mounted on a
distal end of a carrier arm coupled to the distal end of the
surgical robotic arm, and a housing of the surgical tool is movably
coupled to a tool driver mounted on a proximal portion of the
carrier arm.
7. The method of claim 1, wherein the tool holder is positioned
against an outer surface of a patient to mimic the function of a
trocar.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] This application is a divisional of U.S. patent application
Ser. No. 15/380,490 filed Dec. 15, 2016, entitled "Trocar
Simulation," which is hereby incorporated by reference in its
entirety.
FIELD
[0002] Methods and devices are provided for supporting an elongate
shaft on a surgical tool during robotic surgery.
BACKGROUND
[0003] Minimally invasive surgical (MIS) instruments are often
preferred over traditional open surgical devices due to the reduced
post-operative recovery time and minimal scarring. Laparoscopic
surgery is one type of MIS procedure in which one or more small
incisions are formed in the abdomen and a trocar is inserted
through the incision to form a pathway that provides access to the
abdominal cavity. The trocar is used to introduce various
instruments and tools into the abdominal cavity, as well as to
provide insufflation to elevate the abdominal wall above the
organs. The instruments and tools can be used to engage and/or
treat tissue in a number of ways to achieve a diagnostic or
therapeutic effect. Endoscopic surgery is another type of MIS
procedure in which elongate flexible shafts are introduced into the
body through a natural orifice.
[0004] Although traditional minimally invasive surgical instruments
and techniques have proven highly effective, newer systems may
provide even further advantages. For example, traditional minimally
invasive surgical instruments often deny the surgeon the
flexibility of tool placement found in open surgery. Difficulty is
experienced in approaching the surgical site with the instruments
through the small incisions. Additionally, the added length of
typical endoscopic instruments often reduces the surgeon's ability
to feel forces exerted by tissues and organs on the end effector.
Furthermore, coordination of the movement of the end effector of
the instrument as viewed in the image on the television monitor
with actual end effector movement is particularly difficult, since
the movement as perceived in the image normally does not correspond
intuitively with the actual end effector movement. Accordingly,
lack of intuitive response to surgical instrument movement input is
often experienced. Such a lack of intuitiveness, dexterity, and
sensitivity of endoscopic tools has been found to be an impediment
in the increased the use of minimally invasive surgery.
[0005] Over the years a variety of minimally invasive robotic
systems have been developed to increase surgical dexterity as well
as to permit a surgeon to operate on a patient in an intuitive
manner. Telesurgery is a general term for surgical operations using
systems where the surgeon uses some form of remote control, e.g., a
servomechanism, or the like, to manipulate surgical instrument
movements, rather than directly holding and moving the tools by
hand. In such a telesurgery system, the surgeon is typically
provided with an image of the surgical site on a visual display at
a location remote from the patient. The surgeon can typically
perform the surgical procedure at the location remote from the
patient whilst viewing the end effector movement on the visual
display during the surgical procedure. While viewing typically a
three-dimensional image of the surgical site on the visual display,
the surgeon performs the surgical procedures on the patient by
manipulating master control devices at the remote location, which
master control devices control motion of the remotely controlled
instruments.
[0006] While significant advances have been made in the field of
robotic surgery, there remains a need for improved methods,
systems, and devices for use in robotic surgery.
SUMMARY
[0007] Various surgical tools and methods are provided for
supporting an elongate shaft on a surgical tool during robotic
surgery. In one aspect, a tool holder is provided that includes an
elongate carrier arm configured to couple to a distal end of a
surgical robotic arm. The tool holder has a removable housing
mounted on the carrier arm. The housing has an opening formed
therethrough for receiving an elongate shaft of a surgical tool,
and it is configured to be positioned adjacent to a tissue surface
without extending into tissue. The opening has an inner diameter
that is configured to dynamically adjust in size to adapt to and
resist movement of elongate shafts of varying diameters inserted
therethrough.
[0008] The tool holder can vary in numerous ways. For example, the
housing can be mounted on a distal end of the carrier arm, and the
proximal end of the carrier arm can include a tool driver with a
plurality of motors for driving a tool. The opening can include at
least one engagement feature disposed therein that is configured to
adjust the size of the inner diameter of the opening. The inner
diameter can also be configured to automatically dynamically adjust
in size during insertion of an elongate shaft therethrough. In
another example, the opening can include a variety of features,
such as ribs, spring-biased centering balls, spring-biased arms,
semi-segmented balloons, and an elastomeric squeeze fit material
for adjusting a size of the inner diameter of the opening. The
housing can be ring-shaped and mounted on a distal-most end of the
carrier arm.
[0009] In another aspect, a surgical system is provided that
includes a surgical tool with a housing and an elongate shaft
extending from the housing with an end effector at a distal end.
The system has a robotic arm with a tool driver on a distal end
thereof. The tool driver includes a plurality of motors configured
to couple to the housing on the tool for driving the tool. The
system also has a tool holder with an opening formed therethrough
to receive the elongate shaft when the housing is coupled to the
tool driver, and it is configured to be positioned adjacent to a
tissue surface without extending into tissue. The opening includes
at least one engagement feature that is configured to alter a
diameter of the opening such that the opening can receive and
engage elongate shafts of varying diameters.
[0010] The system can vary in numerous ways. For example, the at
least one engagement feature can include at least one biasing
member that is configured to bias the elongate shaft toward a
center of the opening. In certain aspects, the at least one
engagement feature can include at least one of ribs, spring-biased
centering balls, spring-biased arms, semi-segmented balloons, and
an elastomeric squeeze fit material. The elongate shaft can have a
longitudinal axis and the tool holder can be configured to resist a
change in an angular orientation of the elongate shaft relative to
the longitudinal axis. In another example, the tool holder can
include a ring having the opening in a center thereof.
[0011] In another aspect, a surgical method is provided that
includes inserting an elongate shaft of a surgical tool into an
opening of a tool holder mount on a distal end of a surgical
robotic arm. The tool holder is positioned adjacent to a tissue
surface without extending into tissue. The opening dynamically
adapts in size to have an inner diameter that substantially
corresponds to an outer diameter of the elongate shaft such that
the tool holder resists angular forces applied to the elongate
shaft to minimize a bending load applied to the shaft.
[0012] The surgical method can vary in numerous ways. For example,
the opening can have at least one biasing member that biases the
elongate shaft toward a center of the opening to resist angular
forces applied to the elongate shaft. The at least one biasing
member can include, for example, at least one of ribs,
spring-biased centering balls, spring-biased arms, semi-segmented
balloons, and an elastomeric squeeze fit material. The opening can
include a plurality of spring-biased members that are biased toward
a central axis of the opening to adjust a size of the inner
diameter of the opening. The opening can also include at least one
deformable member that deforms to adjust a size of the inner
diameter of the opening. In another example, the tool holder can be
mounted on a distal end of a carrier arm coupled to the distal end
of the surgical robotic arm, and a housing of the surgical tool can
be movably coupled to a tool driver mounted on a proximal portion
of the carrier arm. The tool holder can also be positioned against
an outer surface of a patient to mimic the function of a
trocar.
BRIEF DESCRIPTION OF THE DRAWINGS
[0013] The invention will be more fully understood from the
following detailed description taken in conjunction with the
accompanying drawings, in which:
[0014] FIG. 1 is a perspective view of one embodiment of a surgical
robotic system that includes a patient-side portion and a user-side
portion;
[0015] FIG. 2 is a perspective, partially-transparent view of the
surgical tool of FIG. 1 in a robotic arm with a trocar simulation
device;
[0016] FIG. 3 is a top down view of an embodiment of a trocar
simulation device for receiving a shaft of the surgical tool of
FIG. 1;
[0017] FIG. 4 is a top down view of another embodiment of a trocar
simulation device for receiving the shaft of the surgical tool of
FIG. 1;
[0018] FIG. 5 is a top down view of another embodiment of a trocar
simulation device for receiving the shaft of the surgical tool of
FIG. 1;
[0019] FIG. 6 is a top down view of another embodiment of a trocar
simulation device for receiving the shaft of the surgical tool of
FIG. 1;
[0020] FIG. 7 is a cross-sectional side view of another embodiment
of a trocar simulation device for receiving the shaft of the
surgical tool of FIG. 1; and
[0021] FIG. 8 is a top down view of the trocar simulation device of
FIG. 7 for receiving the shaft of the surgical tool of FIG. 1.
DETAILED DESCRIPTION
[0022] Certain exemplary embodiments will now be described to
provide an overall understanding of the principles of the
structure, function, manufacture, and use of the devices and
methods disclosed herein. One or more examples of these embodiments
are illustrated in the accompanying drawings. Those skilled in the
art will understand that the devices and methods specifically
described herein and illustrated in the accompanying drawings are
non-limiting exemplary embodiments and that the scope of the
present invention is defined solely by the claims. The features
illustrated or described in connection with one exemplary
embodiment may be combined with the features of other embodiments.
Such modifications and variations are intended to be included
within the scope of the present invention.
[0023] Further, in the present disclosure, like-named components of
the embodiments generally have similar features, and thus within a
particular embodiment each feature of each like-named component is
not necessarily fully elaborated upon. Additionally, to the extent
that linear or circular dimensions are used in the description of
the disclosed systems, devices, and methods, such dimensions are
not intended to limit the types of shapes that can be used in
conjunction with such systems, devices, and methods. A person
skilled in the art will recognize that an equivalent to such linear
and circular dimensions can easily be determined for any geometric
shape. Sizes and shapes of the systems and devices, and the
components thereof, can depend at least on the anatomy of the
subject in which the systems and devices will be used, the size and
shape of components with which the systems and devices will be
used, and the methods and procedures in which the systems and
devices will be used.
[0024] Various surgical tool holding devices and methods are
provided in which many of the functions common to a surgical
trocar, such as surgical tool support, are replaced by a tool
holder. Robotic surgical tools generally have a housing and an
elongate tool shaft extending from the housing with an end effector
on a distal end thereof. The housing has a plurality of actuators
for causing various functions of the end effector, such as
rotation, articulation, clamping, firing, stapling, etc. Many
surgical tools with elongate shafts benefit from additional support
provided to the shaft by a trocar during surgical procedures to
center the surgical tool and prevent or limit undesirable bending
loads and/or forces from being applied to the shaft and/or the
surgical tool. When a surgical tool is coupled to a robotic
surgical system, additional bending loads may be applied at an
engagement point between the surgical tool and the robotic surgical
system. A trocar can help reduce the load and stabilize the tool.
However, the use of a trocar may not be ideal in all situations,
such as in thoracic cases. Additionally, a user may want to use a
surgical tool without using a trocar, a user may want to use a
smaller diameter tool that will not receive full support from a
trocar, or a user may not want to insert a trocar abdominally into
a patient. Furthermore, some robotic surgical systems may
incorporate various sensing mechanisms to ensure a trocar is in
place and will not operate without a trocar being sensed. Provided
herein is thus a tool holder configured to receive an elongate
shaft of a surgical tool in an opening therethrough. The opening is
configured to dynamically adjust in size to adapt to and resist
movement of elongate shafts of varying diameters inserted
therethrough. The tool holder is configured to connect to robotic
surgical system arms and to simulate a trocar.
[0025] FIG. 1 is a perspective view of one embodiment of a surgical
robotic system 100 that includes a patient-side portion 102 that is
positioned adjacent to a patient 104, and a user-side portion 106
that is located a distance from the patient, either in the same
room and/or in a remote location. The patient-side portion 102
generally includes one or more robotic arms 108 and one or more
surgical tools and/or tool assemblies 110 that are configured to
releasably couple to a robotic arm 108. The user-side portion 106
generally includes a vision system 112 for viewing the patient 104
and/or surgical site, and a control system 114 for controlling the
movement of the robotic arms 108 and each surgical tool 110 during
a surgical procedure. A person skilled in the art will appreciate
that the surgical robotic system can have a variety of
configurations. One exemplary surgical robotic system is disclosed
in WIPO Patent Publication No. WO2014/151621, filed on Mar. 13,
2014 and entitled "Hyperdexterous Surgical System," which is
incorporated herein by reference in its entirety.
[0026] The surgical tool 110 includes an elongate shaft 122, an end
effector 124, and a tool housing 128 coupled to a proximal end of
the shaft 122. The end effector 124 is configured to move relative
to the shaft 122, e.g., by pivoting, to position the end effector
124 at a desired location relative to a surgical site during use of
the tool 110. The housing 128 includes various components (e.g.,
gears and/or actuators) configured to control the operation various
features associated with the end effector 124 (e.g., any one or
more of clamping, firing, rotation, articulation, energy delivery,
etc.). In at least some embodiments, as in this illustrated
embodiment, the surgical tool 110 is configured to releasably
couple to a tool driver 129 mounted on a carrier 130 on a distal
end of the robotic aim 108. The tool housing 128 can include
coupling features configured to allow the releasable coupling of
the tool 110 to the tool driver 129. The surgical tool 110 can have
any of a variety of configurations. In general, the surgical tool
can be configured to perform at least one surgical function and can
include any of, for example, forceps, a grasper, a needle driver,
scissors, an electrocautery tool that applies energy, a stapler, a
clip applier, a suction tool, an irrigation tool, an imaging device
(e.g., an endoscope or ultrasonic probe), etc. The surgical tool
110 in at least some embodiments is configured to apply energy
(such as radiofrequency (RF) energy) to tissue, while in other
embodiments the tool 110 is not configured to apply energy to
tissue.
[0027] The shaft 122 can have any of a variety of configurations.
In general, the shaft 122 is an elongate member extending distally
from the housing 128 and having at least one inner lumen extending
therethrough. The shaft 122 is fixed to the housing 128, but in
other embodiment the shaft 122 can be releasably coupled to the
housing 128 such that the shaft 122 can be interchangeable with
other shafts. This may allow a single housing 128 to be adaptable
to various shafts having different end effectors.
[0028] The control system 114 can have a variety of configurations
and can be located adjacent to the patient (e.g., in the operating
room), remote from the patient (e.g., in a separate control room),
or distributed at two or more locations (e.g., the operating room
and/or separate control room(s)). As an example of a distributed
system, a dedicated system control console can be located in the
operating room, and a separate console can be located in a remote
location. The control system 114 can include components that enable
a user to view a surgical site of the patient 104 being operated on
by the patient-side portion 102 and/or to control one or more parts
of the patient-side portion 102 (e.g., to perform a surgical
procedure at the surgical site). In some embodiments, the control
system 114 can also include one or more manually-operated input
devices, such as a joystick, exoskeletal glove, a powered and
gravity-compensated manipulator, or the like. The one or more input
devices can control teleoperated motors which, in turn, control the
movement of the surgical system, including the robotic arms 108 and
surgical tools 110.
[0029] The patient-side portion 102 can have a variety of
configurations. As illustrated in FIG. 1, the patient-side portion
102 can couple to an operating table 116. However, in other
embodiments, the patient-side portion 102 can be mounted to a wall,
to the ceiling, to the floor, or to other operating room equipment.
Further, while the patient-side portion 102 is shown as including
two robotic arms 108, more or fewer robotic arms 108 may be
included. Furthermore, the patient-side portion 102 can include
separate robotic arms 108 mounted in various positions, such as
relative to the surgical table 116 (as shown in FIG. 1).
Alternatively, the patient-side portion 102 can include a single
assembly that includes one or more robotic arms 108 extending
therefrom.
[0030] As the surgical tool 110 is used during a surgical
operation, various loads and/or forces are applied to the surgical
tool because of movement of the surgical tool 110 and resistance
encountered by other tools, equipment and/or tissue during the
operation. While the surgical tool 110 can extend through a trocar
(as shown in FIG. 1) to facilitate positioning within a body
cavity, the surgical tool 110 can alternatively extend through a
tool holder 202 coupled to a carrier 204 that attaches to a distal
end of a robot arm (not shown), as illustrated in FIG. 2. The tool
holder 202 can be configured to mimic a trocar without extending
into tissue, and as shown has an opening 206 therethrough sized to
receive the shaft 122 of the surgical tool 110. As illustrated by
the arrow X.sub.1 in FIG. 2, loads and/or forces encountered by the
shaft 122 of the surgical tool 110 during use can cause the
surgical tool 110 to angle away from a center or desired
orientation, and the forces can apply undesired force to any
engagement between the surgical tool 110 and any robotic surgical
system to which it might be coupled, such as the tool driver 129
shown in FIG. 1. The tool holder 202 provides support to the
surgical tool 110 to resist bending, shifting and/or angular
movement of the shaft 122 by engaging the shaft 122 that extends
through the opening 206 of the tool holder 202. The tool holder 202
is in the shape of a ring, but a variety of different shapes can be
used, such as rectangular, oval, etc. The tool holder 202 can be
removably mounted on a carrier 204 on a robotic arm in the same way
that the trocar or trocar support 132 is mounted on the carrier 130
in FIG. 1. A user can thus selectively utilize either a trocar or a
tool holder, as may be desired.
[0031] The tool holder can minimize shaft bending loads, resist
shaft movement, and provide centering of the shaft of a surgical
tool through a variety of different approaches and by using a
variety of different engagement features. In one embodiment
illustrated in FIG. 3, the tool holder 302 has a plurality of crush
ribs 310 disposed therein. The crush ribs 310 are spaced radially
around an inner perimeter of the tool holder 302 such that they
engage a circumference of a tool inserted therethrough. The crush
ribs 310 can be made of a variety of deformable and/or elastic
materials, such as plastic or metal. For example, the crush ribs
310 can be made of a plastic insert on a metallic ring, or the
crush ribs 310 can be entirely plastic. The crush ribs can have
various shapes and sizes, such as triangular as shown. Alternative
configurations include, for example, circular, oblong, square, etc.
The crush ribs 310 extend into an opening 306 of the tool holder
302 through which a shaft of a surgical tool, such as the shaft 122
of the surgical tool 110, is inserted. As the shaft 122 is inserted
through the opening 306, the crush ribs 310 are configured to
resist deformation. As represented by a dotted line D1 in FIG. 3, a
diameter of the shaft 122 is smaller than the opening 306 but large
enough to contact all of the crush ribs 310. When the shaft 122
overcomes the resistance of the crush ribs 310, the crush ribs 310
deform to allow the shaft 122 to be inserted into the opening 306
while maintaining contact with the shaft 122 and resisting further
deformation, consequently resisting bending or tilting of the shaft
122 during use. Because there is a plurality of crush ribs 310
around the opening 306, the crush ribs 310 also maintain
corresponding force around the diameter of the shaft 122 to
maintain the shaft 122 aligned in a longitudinal center of the
opening 306.
[0032] FIG. 4 illustrates another embodiment of a tool holder 402
with spring-loaded arms 410 disposed therein. The spring-loaded
arms 410 are pivotably mounted about a pivot point 412 and extend
into an opening 406 of the tool holder 402 through which a shaft of
a surgical tool, such as the shaft 122 of the surgical tool 110, is
inserted. The spring-loaded arms 410 are biased toward a
longitudinal center of the opening 406, and as the shaft 122 is
inserted through the opening 406, the spring-loaded arms 410 resist
pivotal movement away from the opening 406. As represented by a
dotted line D2 in FIG. 4, a diameter of the shaft 122 is smaller
than the opening 406 but large enough to contact all of the
spring-loaded arms 410. When the shaft 122 overcomes the spring
bias of the spring-loaded arms 410, the spring-loaded arms 410
pivot about the pivot points 412 to allow the shaft 122 to be
inserted into the opening 406 while maintaining contact with the
shaft 122 and resisting further pivoting, consequently resisting
bending or tilting of the shaft 122. Because there is a plurality
of spring-loaded arms 410 around the opening 406, the spring-loaded
arms 410 maintain corresponding force around the diameter of the
shaft 122 to maintain the shaft 122 aligned in the longitudinal
center of the opening 406. The spring-loaded arms 410 can be made
of a variety of materials, such as plastic or metal, and can have
various shapes and sizes, such as triangles, oblongs, squares, etc.
The arms 410 can pivot into recesses formed in the interior wall of
the tool holder 402 as they are forced to pivot from insertion of
an elongate shaft so that enough of each arm 410 extends into the
opening 406 to support the elongate shaft while any extra portion
of the arm 410 that is not required to extend into the opening to
contact and support the shaft will be pivoted into the recess. This
amount will vary depending on a diameter of the shaft.
[0033] FIG. 5 illustrates another embodiment of a tool holder 502
with a plurality of spring-biased centering balls 510 disposed
therein. The spring-biased centering balls 510 each have a spring
510s that biases a ball 510b toward a center of an opening 506 of
the tool holder 502 through which a shaft of a surgical tool, such
as the shaft 122 of the surgical tool 110, is inserted. The springs
510s bias the balls 510b toward a longitudinal center of the
opening 406 so that, as the shaft 122 is inserted through the
opening 506, the springs 510s cause the balls 510b to resist moving
away from the longitudinal center. Because there are a plurality of
spring-biased centering balls 510 around the opening 506, the
spring-biased centering balls 510 maintain corresponding force
around the diameter of the shaft 122 to maintain the shaft 122
aligned in the longitudinal center of the opening 506. As
represented by a dotted line D3 in FIG. 5, a diameter of the shaft
122 is smaller than the opening 506 but large enough to contact all
of the balls 510b of the spring-biased centering balls 510. When
the shaft 122 overcomes the spring bias of the springs 510s, the
balls 510b are compressed out of the opening 506 just enough to
allow the shaft 122 to be inserted into the opening 506 while
maintaining contact with the shaft 122 and resisting further
compression, consequently resisting bending or tilting of the shaft
122.
[0034] Each spring-biased centering ball 510 can be in a cavity in
the holder 502 so that the ball 510b can move in and out of the
cavity as larger or smaller shafts are inserted through the holder
502. Each ball 510b is mated to its corresponding spring 510s so
that the balls 510b do not decouple from the spring 510s or the
holder 502. However, other techniques can be used to retain the
balls within the cavities. The spring-biased centering balls 510
can be made of a variety of materials, such as plastic or metal.
Instead of springs, the balls can be coupled to other compressible
materials that provide the same compressible and adjustable
functionality to the balls.
[0035] FIG. 6 illustrates another embodiment of a tool holder 602
with a semi-segmented balloon 610 disposed therein. The balloon 610
has a plurality of semi-segmented bulbous bumps 610b that are
filled with an inflation fluid, such as air or saline. The bumps
extends into a center of an opening 606 of the tool holder 602
through which a shaft of a surgical tool, such as the shaft 122 of
the surgical tool 110, is inserted. The bulbous bumps 610b create a
narrow passageway in a longitudinal center of the opening 606 so
that, as the shaft 122 is inserted through the opening 606, the
bumps 610b resist moving out of the opening 606. As represented by
a dotted line D4 in FIG. 6, a diameter of the shaft 122 is smaller
than the opening 606 but large enough to contact all of the bumps
610b. As the shaft 122 is inserted into the opening 606, the shaft
122 forces the bumps 610b to compress partially out of the opening
606 just enough to allow the shaft 122 to be inserted into the
opening 606 while maintaining contact with the shaft 122 and
resisting further compression, consequently resisting bending or
tilting of the shaft 122. Because there is a plurality of bumps
610b around the opening 606, the bumps 610b maintain corresponding
force around the diameter of the shaft 122 to maintain the shaft
122 aligned in the longitudinal center of the opening 606. The
semi-segmented balloon 610 can be made of a variety of materials,
such as plastic. The semi-segmented balloon 610 can be inflated
through use of an insufflation mechanism designed to be used by a
trocar in a surgical system to which the tool holder 602 is
attached.
[0036] Another embodiment of a tool holder 702 is illustrated in
FIGS. 7 and 8. The tool holder 702 has an elastomeric material 710
disposed in a channel 704 formed within the body of the tool
holder. The elastomeric material 710 extends into a center of an
opening 706 of the tool holder 702 through which a shaft of a
surgical tool, such as the shaft 122 of the surgical tool 110, is
inserted. The elastomeric material 710 creates a narrow passageway
in a longitudinal center of the opening 706 so that, as the shaft
122 is inserted through the opening 706, the elastomeric material
710 resists moving out of the opening 706. As represented by a
dotted line D5 in FIG. 8, a diameter of the shaft 122 is smaller
than the opening 706 but large enough to contact the elastomeric
material 710. As the shaft 122 is inserted into the opening 706,
the shaft 122 compresses the elastomeric material 710 partially out
of the opening 706 enough to allow the shaft 122 to be inserted
through the opening 706 while the elastomeric material 710
maintains contact with the shaft 122 and resists further
compression, consequently resisting bending or tilting of the shaft
122. The elastomeric material 710 maintains force around the entire
diameter of the shaft 122 to maintain the shaft 122 aligned in the
longitudinal center of the opening 706. The elastomeric material
710 can be made of a variety of materials, such as Silicone,
Nitrile, Ethylene Propylene Diene Monomer (EPDM), Fluoroelastomer
(FKM), Neoprene, etc.
[0037] The engagement features providing support to a tool shaft
discussed above can be locked into place to provide a fixed amount
of support to the tool shaft, for example by using levers and/or
ratchets to lock the spring-loaded arms 410 or the spring-biased
centering balls 510 into a fixed position. A diameter of the
opening can also be adjustable, for example due to the ability of
the engagement feature to move, flex, bend, compress, etc., and/or
due to active adjustment of the diameter by, for example, adding or
removing an inflation fluid or adjusting a position of the
engagement features such as the arms or balls with a knob, lever,
adjustment mechanism, etc. The tool holders can thus be used with a
variety of tools that having varying shaft diameters, such as a
device that is 12 mm at a distal end but only 8 mm mid-shaft, thus
requiring a dynamic adjustment to maintain support on the shaft, or
when using a smaller tool in a larger tool holder generally, such
as an 8 mm tool in a 12 mm tool holder.
[0038] As will be appreciated by a person skilled in the art,
electronic communication between various components of a robotic
surgical system can be wired or wireless. A person skilled in the
art will also appreciate that all electronic communication in the
system can be wired, all electronic communication in the system can
be wireless, or some portions of the system can be in wired
communication and other portions of the system can be in wireless
communication.
[0039] The systems, devices, and methods disclosed herein can be
implemented using one or more computer systems, which may also be
referred to herein as digital data processing systems and
programmable systems.
[0040] A computer system can also include any of a variety of other
software and/or hardware components, including by way of
non-limiting example, operating systems and database management
systems. Although an exemplary computer system is depicted and
described herein, it will be appreciated that this is for sake of
generality and convenience. In other embodiments, the computer
system may differ in architecture and operation from that shown and
described here.
[0041] Preferably, components of the invention described herein
will be processed before use. First, a new or used instrument is
obtained and if necessary cleaned. The instrument can then be
sterilized. In one sterilization technique, the instrument is
placed in a closed and sealed container, such as a plastic or TYVEK
bag. The container and instrument are then placed in a field of
radiation that can penetrate the container, such as gamma
radiation, x-rays, or high energy electrons. The radiation kills
bacteria on the instrument and in the container. The sterilized
instrument can then be stored in the sterile container. The sealed
container keeps the instrument sterile until it is opened in the
medical facility.
[0042] Typically, the device is sterilized. This can be done by any
number of ways known to those skilled in the art including beta or
gamma radiation, ethylene oxide, steam, and a liquid bath (e.g.,
cold soak). An exemplary embodiment of sterilizing a device
including internal circuitry is described in more detail in U.S.
Pat. No. 8,114,345 filed Feb. 8, 2008 and entitled "System And
Method Of Sterilizing An Implantable Medical Device." It is
preferred that device, if implanted, is hermetically sealed. This
can be done by any number of ways known to those skilled in the
art.
[0043] One skilled in the art will appreciate further features and
advantages of the invention based on the above-described
embodiments. Accordingly, the invention is not to be limited by
what has been particularly shown and described, except as indicated
by the appended claims. All publications and references cited
herein are expressly incorporated herein by reference in their
entirety.
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